Comparison between air and gas as tamponade in 25-gauge pars plana vitrectomy for primary superior rhegmatogenous retinal detachment

Amara, Amélie; Bernabei, Federico; Chawki, Mohammad B.; Buffet, J; Raphael, Anthony P.; Sellam, Alexandre; Azan, F.; Lehmann, Mathieu; Guerrier, Gilles; Rodallec, T.; Nordmann, Jean‐Philippe; Rothschild, Pierre-Raphaël

doi:10.1038/s41433-021-01739-z

Cited by 7 publications

(26 citation statements)

References 26 publications

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“…In three studies [9, 18, 20], the preoperative quadrants of RRD were larger in the gas group, and the proportion of PVR change was greater in the gas group in one study [21]. In addition, five [11, 12, 18, 21, 22] and four studies [9, 11, 18, 19] investigated the anatomical success of upper and lower break RRDs, respectively.…”

Section: Resultsmentioning

confidence: 99%

“…Besides, two included studies [10, 23] did not compare the baseline characteristics between the air and gas groups; thus, potential selection bias between the two groups cannot be ruled out. In the overall bias analysis, five observational studies [11, 18, 19, 22] were rated as having a moderate risk of bias, one observational study [20] with a serious risk of bias, and three observational studies [10, 21, 23] with a critical risk of bias. The detailed risk of bias assessment of the included studies is shown in online supplementary Table S2.…”

Section: Resultsmentioning

confidence: 99%

“…A lower causative break was defined as a causative retinal break located between the detached retina’s four and eight o’clock positions. Five studies [11, 12, 18, 21, 22] compared the primary anatomical success rates between air and gas tamponades in the eyes with upper causative breaks. Four studies [9, 11, 18, 19] compared the primary anatomical success rate between air and gas tamponades in the eyes with an inferior causative break.…”

Section: Resultsmentioning

confidence: 99%

“…3a). Quantitative analysis was also performed in three studies [18, 19, 22] with a total of 672 eyes to investigate the prevalence of postoperative ocular hypertension. The definition of ocular hypertension slightly varied among the included studies.…”

Section: Resultsmentioning

confidence: 99%

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Air versus Gas Tamponade for Primary Rhegmatogenous Retinal Detachment: A Systematic Review and Meta-Analysis

Chen¹,

Tsai²,

Hsiao³

et al. 2023

Ophthalmic Res

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Background: Air tamponade’s effectiveness in treatment of rhegmatogenous retinal detachment (RRD) remains unclear. Objective: We aimed to review the surgical outcomes between air and gas tamponade after vitrectomy for RRD. Method: PubMed, Cochrane Library, EMBASE, and Web of Science were reviewed. The study protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO CRD42022342284). The primary outcome was the primary anatomical success after vitrectomy. The secondary outcome was the prevalence of postoperative ocular hypertension. Certainty of evidence was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation system. Results: Ten studies involving 2677 eyes were included. One study was randomized, and the others were non-randomized. The primary anatomical success after vitrectomy was not significantly different between the air and gas groups (odds ratio [OR], 1.00; 95% confidence interval [CI], 0.68–1.48). The risk of ocular hypertension was significantly lower in the air group (OR, 0.14; 95% CI, 0.09–0.24). The certainty of evidence regarding air tamponade having an comparable anatomical outcome and lower frequency of postoperative ocular hypertension in treatment of RRD were low. Discussion: The current evidence base for tamponade selection in treatment of RRD has several major limitations. Further appropriately designed studies are needed to guide tamponade selection.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Air versus Gas Tamponade for Primary Rhegmatogenous Retinal Detachment: A Systematic Review and Meta-Analysis

Chen¹,

Tsai²,

Hsiao³

et al. 2023

Ophthalmic Res

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“…Pooled data for investigating BCVA were obtained from 4 studies [12, 13, 15, 17]. Results from our meta-analysis comparing the mean BCVA at baseline and mean postoperative BCVA at 3 months, as well as the mean change in BCVA between the air tamponade and gas tamponade groups (shown in Fig.…”

Section: Resultsmentioning

confidence: 99%

The Efficacy and Safety of Air Tamponade in the Repair of Rhegmatogenous Retinal Detachment: A Systematic Review and Meta-Analysis

Zhu¹,

Wu²,

Yuan³

et al. 2023

Ophthalmic Res

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Background: Rhegmatogenous retinal detachment (RRD) repair by pars plana vitrectomy (PPV) combined air tamponade has many advantages compared with PPV combined gas tamponade. However, there are controversial outcomes in RRD cases involving the lower quadrants. Objective: This study aimed to evaluate the efficacy and safety of PPV combined air tamponade in patients with RRD compared with PPV combined gas tamponade and whether it could be a safe alternative to PPV combined gas tamponade. Methods: The PubMed, Embase, and Cochrane Library databases published until September 2022 were comprehensively searched for studies that compared PPV combined with air tamponade and gas tamponade in patients with RRD. The rate of primary treatment success, best-corrected visual acuity (BCVA), and postoperative complications were extracted from the final eligible studies. The mean difference (MD) and risk ratio (RR) were calculated for continuous and dichotomous variables, respectively, with 95% confidence intervals (CIs). Results: A total of 8 studies with 668 eyes in the air tamponade group and 944 in the gas tamponade group were included. There was no significant difference in the rate of primary treatment success between the air tamponade group and the gas tamponade group (RR = 1.00, P = 0.79). In addition, the subgroup analysis suggested that whether retinal breaks were located above or below, there was no significant difference in either rate of primary treatment success (RR = 0.99, P = 0.89; RR = 1.02, P = 0.45). There was no significant difference in mean BCVA 3 months after surgery (MD = -0.02, P = 0.50). For postoperative complications, mean postoperative IOP was lower in the air tamponade at one day (MD = -4.24, P < 0.001), and there was no significant difference between the two groups at 7 days (MD = -0.45, P = 0.71), one month (MD = -0.69, P = 0.33), and 3 months (MD = 0.69, P = 0.35) after surgery. The rate of epiretinal membrane (ERM) development was lower in the air tamponade group (RR = 0.48, P = 0.04). Conclusions: For patients with uncomplicated RRD, PPV combined air tamponade is a feasible and safe alternative to PPV combined gas tamponade, regardless of the position of retinal breaks, with a similar primary treatment success rate, postoperative BCVA, and fewer postoperative complications.

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Do Daily Activities Affect Gas Tamponade‒retina Contact After Pars Plana Vitrectomy?

Rossi

Badas

DEng

et al. 2023

Retina

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Purpose: To calculate the retinal surface alternatively in contact with gas and aqueous because of fluid sloshing during daily activities such as ocular saccade, turning the head, standing up, and being a passenger of a braking car.Methods: Fluid dynamics of aqueous and gas tamponade was reproduced using computational methods using the OpenFOAM open-source library. The double-fluid dynamics was simulated by the volume of fluid method and setting the contact angle at the aqueous-gas-retina interface.Results: Sloshing increased the retinal surface in contact with aqueous by 13% to 16% regardless of fill rate and standing up determined the largest area of wet retina, followed by car braking, head rotation, and ocular saccade (P , 0.001). All activities except the ocular saccade determined a significant increase in the surface of retina in contact with the aqueous (P , 0.005). Car braking induced the highest shear stress (6.06 Pa); standing up determined the highest specific impulse and saccade the lowest.Conclusion: Daily activities instantaneously reduce the amount of retina consistently in contact with gas tamponade and increase shear stress giving aqueous a potential access to the subretinal space regardless of patients' compliance.

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Comparison between air and gas as tamponade in 25-gauge pars plana vitrectomy for primary superior rhegmatogenous retinal detachment

Cited by 7 publications

References 26 publications

Air versus Gas Tamponade for Primary Rhegmatogenous Retinal Detachment: A Systematic Review and Meta-Analysis

Air versus Gas Tamponade for Primary Rhegmatogenous Retinal Detachment: A Systematic Review and Meta-Analysis

The Efficacy and Safety of Air Tamponade in the Repair of Rhegmatogenous Retinal Detachment: A Systematic Review and Meta-Analysis

Do Daily Activities Affect Gas Tamponade‒retina Contact After Pars Plana Vitrectomy?

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